<div class="row">
  <div class="col-xs-12">
    <div class="box box-primary">
      <div class="box-header">
        <h3 class="box-title">Tambah Data Keluarga</h3>
      </div><!-- /.box-header -->
      <?php echo form_open('master_agama/save', array('role' => 'form', 'id' => 'form'));?>
      <div class="box-body">				        
        <!-- text input -->
        <div class="form-group">
          <label>Nomer KK</label>
         	<input class="form-control input-sm" name="nomer_kk" type="text" placeholder="Nomer KK">
        </div>
        <div class="form-group">
          <label>Alamat</label>
         	<input class="form-control input-sm" name="alamat" type="text" placeholder="Nama agama">
        </div>
        <div class="form-group">
          <label>RT</label>
         	<input class="form-control input-sm" name="rt" type="text" placeholder="Nama agama">
        </div>
        <div class="form-group">
          <label>RW</label>
         	<input class="form-control input-sm" name="rw" type="text" placeholder="Nama agama">
        </div>
        <div class="form-group">
          <label>Kecamatan</label>
         	<input class="form-control input-sm" name="kecamatan" type="text" placeholder="Nama agama">
        </div>
        <div class="form-group">
          <label>Kelurahan</label>
         	<input class="form-control input-sm" name="kelurahan" type="text" placeholder="Nama agama">
        </div>
      </div>		                   
      <div class="box-footer">
        <button type="submit" class="btn btn-sm btn-primary btn-flat"><i class="fa fa-floppy-o"></i> Simpan</button>
      </div>
			<?php echo form_close();?>
    </div><!-- /.box -->                            
  </div>
</div>

<script>
	$("#form").validate({
		rules: {
			agama: {
				required: true
			},
		}
	});
</script>